2013 Producer Resource Guide

Transcription

1 2013 Producer Resource Guide

2 Thank you for certifying to market, sell and/or service Blue MedicareRx SM. Here is your 2013 Blue MedicareRx Producer Resource Guide. It is a convenient summary of the Rules of the Road for being a successful certified Blue MedicareRx producer. We will keep you updated on important changes and notifications throughout the year in our newsletter, Medicare Blue Notes for Producers. Archived issues of Blue Notes can be found on our Blue Access for Producers SM (BAP) Web page. Select the 2013 Blue MedicareRx link. Remember, business opportunities are knocking with Blue MedicareRx. That s because every day for the next 16 years about 7,000 Baby Boomers will turn 65*. As a Blue MedicareRx certified producer, you are well positioned to take advantage of these significant income opportunities. Please look through this Guide and keep it handy as a reference. Sincerely, William J. Trees Director, Consumer Markets This Resource Guide can be downloaded to your laptop or desktop for quick reference or printed as a hard copy. Web links throughout this Resource Guide are live and will take you directly to the site. * Insured Retirement Institute, Boomer Expectations for Retirement, April

3 Helping with the decision The Blue MedicareRx Decision Guide includes tools to help with the decision-making process. The guide covers: the phases of Medicare Part D creating a personal prescription drug list Blue MedicareRx PDP plan options a worksheet on how to pick a plan overviews of the formulary and the pharmacy network Life offers you many choices. It s time to choose the right prescription drug plan. Through It All. SM ILRXDG13 S5715_MRK_TMP_IL_FULFILLSWIT13b Approved Target This Decision Guide was developed for all audiences. current members switchers caregivers those who are turning 65 Remember, to purchase a Blue MedicareRx plan, the new member must already have Original Medicare (Parts A and B). Someone reading the Decision Guide may have these questions or concerns: Should I stay in my current plan or switch to a new one? Am I paying too much? Are my medications still covered? How can I save money? If I don t enroll, am I penalized? Do I need Part D? If not now, when? Which plan is right for me? Can I change it later? Applicable Enrollment Periods Initial Enrollment Period (IEP) Marketing and Enroll Dates: 3 months before, month of and 3 months after 65th birthday/ start of eligibility AEP (Annual Enrollment Period) Marketing Dates: October 1 December 7 Enroll Dates: October 15 December 7 Special Enrollment Period (SEP) [may not apply to all enrollees] For members and spouses who are currently working, are covered by a group health plan through an employer or union, and will lose their group health coverage. Enrollment dates will vary depending on the situation. General Enrollment Period For someone who misses their Initial Enrollment Period. Enroll Dates: January 1 March 31 You may have to pay a higher premium for late enrollment. Effective Date Generally, 1st of month following receipt of enrollment, but not before enrollee s birthday month January 1 Varies by SEP circumstance July 1 2

4 Does your client need Medicare Supplement insurance 1? Your client may also consider Blue Medicare Supplement SM insurance to help cover some expenses that Original Medicare (Parts A and B) doesn t cover, such as copayments, coinsurance and deductibles. Medicare Supplement insurance plans are standardized plans set by Medicare. Members can use any provider and hospital that accepts Medicare. The chart below shows that your client s out-of-pocket costs for Part A alone could be $57,424 2 if he or she does not have Medicare Supplement insurance. Cost savings chart Hospital Stay $1,184 Days 1-60 $8,880 Days $296/Day Skilled Nursing care $0 Days 1-20 $35,520 Days $592/Day $11,840 Days $148/Day $45,584 + $11,840 = Without a Medicare Supplement insurance plan, your out-of-pocket costs for Part A alone could be... $57, Not connected with or endorsed by the U.S. Government or Federal Medicare Program. 2 Based on an unusual or unique claim. 3

5 Does your client need Medicare Supplement insurance? (cont.) A Medicare Supplement insurance plan customer may be someone who is: turning 65 and planning to retire 65 or over and losing coverage under a group health plan (either theirs or their spouse s) switching from another insurance carrier during the Annual Enrollment Period a Medicare beneficiary who wishes to add a Medicare Supplement insurance plan to his or her retiree or COBRA coverage and his or her Medicare coverage a Part D member who wants to add coverage When talking about Medicare Supplement insurance, potential members may have these questions: What are my current health care needs? How might my needs change over the next few years? How much of my health care does Original Medicare cover? Do I travel often outside the United States? Do I already have enough coverage? 4

6 To help you build business and make it easier to serve your clients, Blue MedicareRx has developed a variety of marketing and enrollment materials. These materials are CMS-approved and ready to use. To order approved Blue MedicareRx marketing and/or enrollment materials, follow the simple steps below. 1. Go to 2. If you registered in 2012, your login information will not work for Use your 9 digit HCSC Assigned Producer ID# for User Name and Newblue1* for password. 4. Change your password upon logging in. 5. Select the 2013 Blue MedicareRx catalog. 6. Review the folders and add items to your shopping cart. Start here: If you have any questions about the about the portal or issues logging in, send an to bcbssupport@worldmarkinc.com. Supplies, such as Decision Guides, appointment reminders, ads and lead generators, forms, etc., are available and listed in the following four categories: Decision Guide Events Forms Sales and enrollment (for example, pharmacy directory) You can also order Under 65 and Medicare Supplement marketing and enrollment materials from this site. REMEMBER: All Medicare Part D marketing and enrollment materials require CMS approval. This marketing rule was outlined in the 2013 HISC Medicare Products Training and Certification Program that you recently completed. Order your CMS-approved Blue MedicareRx marketing materials at 5

7 ILRXDG13 S5715_MRK_TMP_IL_FULFILLSWIT13b Approved Below is a description of the 2013 Blue MedicareRx materials approved by CMS. Order these at Recommended materials These recommended and CMS-approved marketing/sales materials were designed to help you grow your business and provide an enhanced customer experience. Appointment Reminder Confirming our appointment sample ILAPPTCFM13 H3822_MRK_TMP_APPT13 Approved Remind your prospects about your upcoming appointment with this friendly postcard. Available in bulk supply, you just address the postcard and send it on! Forms Scope of Appointment Automatic premium payment (ACH) Protected Health Information (PHI) Appointment of Representative Decision Guide Use the 2013 Decision Guide to walk each prospect through the decision-making process, addressing his or her specific concerns. The guide features a Plan Overview, My Prescription Drug List chart and Pick A Plan worksheet, as well as enrollment instructions. Decision Guide Life offers you many choices. It s time to choose the right prescription drug plan. sample Through It All. SM 6

8 Kaiser Family Foundation. Medicare at a Glance Fact Sheet; (2011, November). Other available materials These additional Blue MedicareRx approved materials are available to help you better engage prospects and be an even more knowledgeable resource for customers. Sales Presentation Use this easy-to-follow, 45-minute presentation at your sales events. Stand-Alone Tools The following items are available as stand-alone pieces. These should be used as a quick reference and ordered in moderation. Formulary ( Drug List ) Pharmacy Directory Summary of Benefits Education Only Tools These items are strictly educational, with no sales or Blue MedicareRx product specific messages. Medicare Basics a useful tool for explaining the fundamentals of Medicare to caregivers or those turning 65. These can be ordered in convenient pads of 25. Part D Basics Education Presentation Medicare Supplement Education Presentation Medicare Basics How does Medicare work? Medicare is the nation s largest health insurance program, covering health care services such as hospital stays, skilled nursing and physician services for about 49 million people. 1 There are four parts to Medicare, each providing different types of health care services. PART A Hospital Insurance Helps pay for inpatient hospital care, skilled nursing facility care, home health care and hospice care. While most Americans are enrolled automatically in Medicare Part A, it alone may not cover all of your health care costs. Parts B, C and D are voluntary programs that provide additional coverage. A PART PART Medical Insurance B Helps pay for covered doctor s services and many other medical services and supplies. If you don t enroll in Part B when you are first eligible for Medicare, you may have to pay a penalty later. PART B C PART PART C PART PART Medicare Prescription Advantage Plans D Drug Coverage D Offers medical coverage through Helps pay for covered prescription a network of providers, such as an medications. As with Part B, sample HMO or PPO, that is an alternative selecting a Part D plan when you to Original Medicare (Parts A & B). are first eligible means you may not These plans may or may not cover have to pay a penalty later. prescription drugs. Medicare Supplement Insurance Optional coverage helps to pay for expenses beyond what is covered by Medicare. There are several Medicare Supplement insurance plans, each with different benefits and premiums, so you can choose the plan that works best for your specific needs. Medicare Supplement insurance plans are identified by the separate letters A through N. 2 The basic benefits of each plan are exactly alike for all insurance companies. 7

9 FAQs (frequently asked questions) Ordering Part D supplies Where are the sales kits? The Decision Guide and sales kits are the same thing. Why can t I order enrollment forms instead of having to order the full Decision Guide? Why are there minimums and maximums? The Medicare Marketing Guidelines state a Medicare beneficiary must be presented with certain pieces of information at the time of enrollment, including, but not limited to, appeal/grievance and limitations and exclusions language. This information is not on the enrollment form, but is included in the Decision Guide so the two must always be distributed together. In order to be cost-effective, minimum and maximum quantities have been set. These ranges were set to meet your needs. How long does it take to get my order? State Production Shipping Total Illinois 3 days 1-2 days 4-5 days New Mexico 3 days 4-5 days 7-8 days Oklahoma 3 days 2-3 days 5-6 days Texas 3 days 3-4 days 6-7 days What if I need my order sooner? Can I have it shipped overnight? No. Overnight shipments are not available. What if I need an item that s not at If you need something that s not available, please contact your Marketing Consultant or local sales office to discuss options. REMEMBER: All materials distributed to a prospect and/or member require Blue MedicareRx and CMS approval PRIOR to distribution. 8

10 Before setting an appointment, identify the prospect s needs and priorities. This is a key element in setting up and conducting successful appointments. Important information to gather about your prospect includes: Does the prospect have coverage now? If so, is it creditable? Is the prospect concerned about costs/budget? Have his/her drug needs or health changed recently? Does he/she just want protection/insurance for the future? Once you ve identified your prospect s needs, you ll want to use these tools to help ensure a successful meeting with the beneficiary. These tools include: Tool Scope of Appointment form Appointment reminder Appointment of Representative When to Use Must be used for a new client or for an existing member/client. Review the next page in this Resource Guide for additional details about the Scope of Appointment form. Use this postcard to remind prospects of your upcoming appointment. Keep these on hand so you can mail the reminder the same day you make the appointment. If you are meeting with a caregiver who is likely to become the enrollee s authorized representative, you may wish to take the Appointment of Representative form with you. This will ensure that the authorization has been granted, especially if the enrollee inadvertently neglects to complete that section on the Enrollment Form. Go to to order any of the materials listed above. 9

11 Using the Scope of Appointment Form The Scope of Appointment requirement is one of the most important requirements producers must meet. But it is also one of the requirements about which producers most frequently need clarification or have questions. Below is a summary that details when an executed Scope of Appointment form is required. Please note that this is not an exhaustive list. If you encounter a situation not listed here, contact the Producer Help Desk for clarification on how to proceed. Situation SOA Form Needed? Reason Hint Discussing Medicare products on the phone No A beneficiary requesting product-specific information on an inbound phone call does not require an SOA form. A Scope of Appointment Form is needed if that telephone call results in a marketing appointment. Meeting with a beneficiary who attended a sales event Yes Meeting a beneficiary outside the sales event is considered a face-to-face appointment. Complete the SOA form at the sales event to avoid doing so later. Beneficiaries attending a sales event that was previously advertised No The advertising details what products are being discussed and the beneficiaries have chosen to attend. Be sure to also announce what products are being discussed at the beginning of the presentation. Beneficiary visits sales agent s office unannounced Yes Although a previous appointment was not scheduled, a face-to-face meeting is occurring. Complete the Scope of Appointment Form before the meeting begins and add WALK IN at the top of the form. Document why the form wasn t completed 48 hours in advance of meeting. A beneficiary wants to schedule a meeting while attending an education event No A Scope of Appointment Form is considered a marketing activity and marketing/selling is prohibited at education events. Use education events to discuss Medicare Parts A, B, C, D and the types of Medicare products available and/or combinations. Do not discuss plan-specific benefits or information. 10

12 Scope of Appointment Reminders 1. At least 48 hours before meeting with a Medicare beneficiary, a Scope of Appointment (SOA) form must be completed, signed by the beneficiary, and returned to the producer. 2. The SOA form can be sent to and/or received from the beneficiary via mail, fax or . NOTE: An exchange does not meet the Scope of Appointment requirement. The signed and completed form must be attached to the . As detailed in the Marketing Guidelines issued by the Centers for Medicare and Medicaid (CMS), a phone recording of a producer scheduling a sales appointment also does not meet the Scope of Appointment requirement. 3. The signed SOA form signifies that the beneficiary voluntarily agrees to meet with the producer and has chosen which health-related Medicare product(s) will be discussed at the appointment. 4. The Scope of Appointment form should be kept on file for the current year + ten (10) additional years. 5. Scope of Appointment forms are available on the Blue Access for Producers website, or also at By signing this you are agreeing to a sales meeting with a sales agent to discuss the specific types of products you initialed above. The person that will be discussing plan options with you is either employed or contracted by a Medicare health plan or prescription drug plan that is not the Federal government, and they may be compensated based on your enrollment in a plan. Scope Signing of Sales this does Appointment NOT affect your Confirmation current enrollment, Form nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plan. To be completed by person with Medicare. Please initial below in the box beside the plan type that you want the agent to discuss with you. If you Beneficiary do not want Signature: the agent to discuss a plan type with you, please leave the box empty. (Please note that an agent may also discuss a Medicare Supplement policy with you.) If you are the authorized representative, you must sign above and provide the following information: Stand-alone Medicare Prescription Drug Plans (Part D) Name: Medicare Address: Prescription Drug Plan (PDP) A stand-alone drug Phone plan number: that adds prescription drug coverage to the Original Medicare Plan, some Medicare Cost Relationship to Beneficiary: Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. Medicare Advantage (Part C), Medicare Advantage To be completed by Agent: Prescription Drug Plans, and other Medicare Plans Agent Name: Agent Phone: Medicare Health Maintenance Organization (HMO) A Medicare Advantage Plan that must cover all Part A and Part B health care. In most HMOs, you can only go to Beneficiary doctors, specialists, Name: or hospitals in the plan s network except Beneficiary in an Phone: emergency. Medicare Preferred Provider Organization (PPO) Plan A type of Medicare Advantage Beneficiary Plan available Address: in a local or regional area in which you pay less if you use doctors, hospitals, and providers that belong to the network. You can use doctors, hospitals, and providers outside of the network for an additional cost. Medicare Initial Private Method Fee-For-Service of Contact: (PFFS) Plan A type of Medicare Advantage (Indicate Plan in here which if beneficiary you may was go a to walk-in.) any Medicare-approved doctor or hospital that accepts the plan s payment and terms and conditions. Agent s Signature: Medicare Special Needs Plan (SNP) A special type of Medicare Advantage Plan that provides more focused and specialized health care for specific groups of people, such as those who have both Medicare and Medicaid, who reside in a Plan Use Only: nursing home, or have certain chronic medical conditions. Medicare Medical Savings Account (MSA) Plan MSA Plans combine a high deductible Medicare Advantage Plan and a bank account. The plan deposits money from Medicare in the account. You can use it to pay your medical expenses until S5715_S5566_MRK_SCOPEAPPTFRM10 CMS Approved 09/2009 your deductible is met. Medicare Cost Plan A type of health plan. In a Medicare Cost Plan, if you get services outside of the plan s network without a referral, your Medicare-covered services will be paid for under the Original Medicare Plan (your Cost Plan pays for emergency services, or urgently needed services). The Scope of Appointment requirement is one of the most important requirements producers must meet. 11

13 Selling Blue MedicareRx Here is a simple checklist to help ensure you have taken all of the required steps for every appointment with a prospect. These important To Do s during each meeting with the prospect include: 1. Use the Decision Guide to help your prospect find the plan that best meets his/her needs: Assist your prospect with filling out the My Prescription Drug List chart using the 2013 Comprehensive Drug List. Discuss the Plan Overview and fill out the Pick A Plan Worksheet together. 2. After your prospect has chosen a Blue MedicareRx plan that fits his/her needs, complete the following: Determine enrollment period and confirm eligibility. Find out if the prospect needs/qualifies for Extra Help. Confirm whether he/she wants to designate an authorized representative. Verify how he/she wants to enroll: online or by mail. Establish which payment method the beneficiary wants to use. Appointment Checklist continues on next page. 12

14 Selling Blue MedicareRx Appointment Checklist (continued) 3. Double-check that all of the following items have been addressed during each meeting with a prospect. eligibility requirements, including: continuing enrollment, as applicable, in Medicare A and/or B continuing to pay Medicare Part B premium being enrolled in only one Medicare plan at a time premiums and cost-sharing for the appropriate plan year, including: deductible, if applicable copayments and/or coinsurance gap coverage, including True Out-of-Pocket costs (overview of what counts and doesn t count) and generic and brand discount programs catastrophic coverage explanation of Income Related Market Adjusted Amount (IRMAA) network rules, including: using network pharmacies to receive benefits using out-of-network pharmacies in emergency situations and payment liability preferred network pharmacy vs. non-preferred network pharmacy formulary description, including: tier structure Utilization Management programs overviews of exception and transition processes grievances and appeals, including: a high level overview: what they are, when to use, how to initiate the process enrollment options, including: authorized representative communications (acknowledgement, confirmation letters, and ID card) 12-month lock in billing options, including: paper bill if no billing option is selected; change billing option any time delinquency process 13

15 FAQs (frequently asked questions) Selling Blue MedicareRx: Creditable Coverage What is creditable coverage? Creditable coverage is any non-part D source that is equal to or better than the Medicare drug benefit, such as: Existing coverage under a PDP or MAPD plan State Pharmacy Assistance Program (SPAP) Veteran Affairs (VA) coverage Military coverage, including TRICARE Some group health plans (GHP) retiree coverage, for which those eligible are notified by their previous employers What if a client is losing creditable coverage and wants to enroll in Blue MedicareRx? You and your client should review and keep all documents stating his/her coverage is ending. It may be needed during enrollment. Encourage your client to enroll in Blue MedicareRx within 63 consecutive days of the creditable coverage termination date to avoid paying a late enrollment penalty. What if my client isn t losing creditable coverage but wants to switch to Blue MedicareRx anyway? Your client can do so during: Annual Enrollment Period (AEP), or Group/agency s designated open enrollment period. If he/she disenrolls from creditable coverage during the group/ agency s open enrollment period, he/she should enroll in Blue MedicareRx within 63 consecutive days or a late enrollment penalty may be assessed. Extra Help What is Extra Help? Extra Help, also called Low Income Subsidy (LIS), is a Social Security Administration (SSA) program that provides assistance paying for prescription drugs (premium, deductible and copayments/coinsurance) to Medicare beneficiaries who have limited income and resources. How do I know if a client is eligible? You won t. Per CMS, you must inform each Part D beneficiary you meet about the following information regarding Extra Help: is available is based on combined savings, investments, and real estate (other than their home) worth a specific, annually reviewed amount. (Amounts differ for singles vs. married couples living together.) can be applied for through the Social Security Administration (SSA) or local Medicaid office. Applicants are notified by SSA if they are approved or denied. The beneficiary will be enrolled in his/her chosen Blue MedicareRx plan and billed until his/her application is approved. If your client is approved for Extra Help, he/she will receive a rider to his/her Evidence of Coverage (EOC) outlining monthly premium, deductibles, and copays/coinsurance. Billing When does billing occur? Billing occurs monthly: Paper statements are run the first weekend of the previous month. For example, April billing is processed the first weekend of March. ACH withdrawals occur on or about the 5th of each month. SSA and Railroad Retirement Board benefit check deductions are posted at the end of each month (i.e., April payment on April 30). 14

16 Three Ways to Enroll Below are three ways to enroll your prospect in Blue MedicareRx and what you need to do to ensure you receive compensation. Web Log in to Blue Access for Producers Click on the 2013 Blue MedicareRx Information Go to the Enrollment page What do I need to do to receive compensation? 1. Complete the paper enrollment form, including client signature, and keep in client file. 2. Transfer the data to the online form. 3. Answer producer-related questions at the end of the form. a. Producer name and ID # b. Agency, if applicable c. Various attestations 4. Print completed online form and/ or confirmation page, which includes the confirmation number, and keep in client file. Use the confirmation number for enrollment status/tracking purposes. Mail Complete the paper enrollment form, including plan selection and client signature, and make a copy for your client s file. All mailed applications must be POSTMARKED within 24 hours of the producer receipt/signature date. Send the form to: Blue MedicareRx 25 Lakeview Drive Jessup, PA What do I need to do to receive compensation? 1. Ensure the producer section of the enrollment form is complete. a. Producer name and ID # b. Agency, if applicable c. Various attestations NOTE: Missing or illegible information will delay your compensation. Fax Complete the paper enrollment form, including plan selection and client signature, and make a copy for your client s file. All faxed applications must be FAXED within 24 hours of the producer receipt/signature date. Fax the form to: What do I need to do to receive compensation? 1. Ensure the producer section of the enrollment form is complete. a. Producer name and ID # b. Agency, if applicable c. Various attestations NOTE: Missing or illegible information will delay your compensation. Print clearly and fill out the form completely to receive your compensation. 15

17 After the enrollment is submitted These are the important communications that your client will get after enrolling: Enrollees receive many communications throughout the enrollment process. They receive: Acknowledgement Letter We will send a letter within 10 days of receiving your prospect s enrollment form. Verification Phone Call Blue MedicareRx will call the prospect to confirm that he/she indeed did enroll through you and he/she received all required information prior to enrollment. Confirmation Letter/ID Card After your client s enrollment has been approved, we ll send another letter confirming enrollment. This letter will also contain the enrollee s Blue MedicareRx ID card and the date coverage will be effective. Welcome Kit This package includes the Evidence of Coverage that explains what the enrollee needs to know about being a member of Blue MedicareRx. Verification calls are necessary. Here s why: CMS requires us to make enrollment verification calls to all new enrollments that have producer involvement to confirm that the member understands the plan in which he/she has enrolled. The name of our company does not appear on phones with Caller ID, so members may not realize we are trying to reach them. Please explain to your client that he/she can expect a call from Blue MedicareRx and that our name may not appear on the Caller ID. We try to reach the enrollee several times via telephone. If we are unsuccessful, we mail a letter to the enrollee. What is the Customer Service number? TTY/TDD a.m. - 8 p.m., local time, 7 days a week. If you are calling between February 15 through September 30 then alternate technologies (for example, voic ) will be used on the weekends and holidays. 16

18 There are many useful resources available to support you when servicing Blue MedicareRx members. These resources were developed to help producers provide the customer service excellence that Blue MedicareRx members expect. Producer Help Desk With its dedicated team of representatives, this Call Center assists producers with questions related to: enrollment status effective dates ID card requests When calling the Producer Help Desk, producers will need to provide their name and ID number in order to access the Blue MedicareRx member s information. Sales agents will need to have the member s information available as well. This information includes: name Blue MedicareRx identification number Social Security Number, or HICN/Medicare number date of birth complete address Blue Access for Producers Blue Access for Producers is an online tool that serves as a centralized location from which producers can access information, tools and other resources to manage their Blue MedicareRx business. Most common service questions Requesting an ID card or Welcome Kit: Call the Producer Help Desk for a duplicate kit or card. Each will be sent directly to the member. Changing an effective date: You can t change an effective date. CMS Enrollment Guidelines establish the effective dates and we are not permitted to change them unless an error was made during processing. 17

19 FAQs (frequently asked questions) Enrollment Why does the paper form need to be postmarked within 24 hours of the receipt/signature date? Blue MedicareRx must receive all applications as quickly as possible, but never later than 5 days from the producer signature date. This is critical in order for HISC to meet the CMS required time frames of submitting application data to CMS within 7 days and sending an acknowledgment letter to the new member within 10 days. How can I track my client s enrollment status? Contact the Producer Help Desk: Online enrollments - use the confirmation number your client received at the time of enrollment. Paper or fax enrollments - provide the enrollee s name and Medicare number (or Social Security Number, if available). You may have to confirm date of birth and/or address. What if I can t find the online confirmation number? Provide enrollee name and Medicare number (or Social Security Number, if available). You may need to confirm the member s date of birth and/or address. How do I switch from one Blue MedicareRx plan to another? Treat the change as a new enrollment and complete the appropriate enrollment vehicle. REMEMBER: Members can switch plan designs only once a year, during the AEP (October 15 - December 7) unless they are eligible for a Special Enrollment Period (SEP). Members who are dual eligible (Medicare and Medicaid eligible) can switch monthly. Can I cancel a submitted enrollment? Enrollment can be cancelled as long as enrollee notifies us prior to the effective date of his/her coverage. These requests are taken verbally and do not require written documentation. Late Enrollment Penalty What is a late enrollment penalty (LEP)? LEP is a penalty imposed by the federal government upon those who do not enroll in a Medicare prescription drug plan when the beneficiary is first eligible or within the established time frame (63 consecutive days) of losing or dropping creditable coverage. The penalty is 1% for each month not enrolled without creditable coverage. 18

20 Contact Information: Contact Phone or Website Purpose Producer Help Desk Note: Producer of Record Verification Process: You will be asked for Producer ID number and Member s ID number, date of birth and address a.m. 5 p.m. Central time Get help with enrollment status general benefit and formulary information disenrollment processes Blue Access for Producers Illinois: New Mexico: Oklahoma: Texas: Your online resource for information about Blue MedicareRx plans, guidelines and other marketing information. Plus, all communications will be posted here, including LifeTimes newsletter, Medicare Blue Notes for Producers, and more. Order Marketing Supplies Order your Blue MedicareRx marketing materials here. Producer Administration Internet Help Desk Call with questions about compensation status and statements. Technical questions regarding logging into Blue Access for Producers. Fraud Waste & Abuse Hotline Report suspected fraud. 19

21 Blue MedicareRx (PDP) is a stand-alone prescription drug plan offered by HCSC Insurance Services Company (HISC), an Independent Licensee of the Blue Cross and Blue Shield Association under contract S5715 with the Centers for Medicare and Medicaid Services. A stand-alone prescription drug plan with a Medicare contract